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Flu Vaccine

For the 2017-18 season, trivalent influenza vaccines licensed in the U.S. will contain hemagglutinin (HA) derived from an A/Michigan/45/2015 (H1N1) pdm09-like virus, an A/Hong Kong/4801/2014 (H3N2)-like virus, and a B/Brisbane/60/2008-like virus (B/Victoria lineage). Quadrivalent influenza vaccines will contain these antigens along with a B/Phuket/3073/2013-like virus (B/Yamagata lineage). 

Recommendations from the ACIP

Flu vaccine is recommended annually for everyone 6 months of age and older who does not have a contraindication. Those too young to be immunized benefit from maternal antibodies passed through the placenta by a mother who was vaccinated during her pregnancy and by being surrounded by immunized friends and family members. Healthcare providers should vaccinate with any appropriate available flu vaccine formulation to avoid missed opportunities. Begin offering vaccine as soon as it becomes available. Peak influenza activity does not generally occur until February. Providers are encouraged to continue vaccinating patients throughout the influenza season, including into the spring months. 

The Morbidity and Mortality Weekly Report published on August 25, 2017 provides guidance from the Advisory Committee on Immunization Practices (ACIP) for using this year's flu vaccine products. See this PDF for a for a listing of influenza vaccine products available for the 2017-18 season.

Updates for 2017-18 flu vaccine

  • Due to studies showing low effectiveness during the 2013-14 and 2015-16 seasons, the Advisory Committee on Immunization Practices (ACIP) has recommended that  nasal spray flu vaccine not be used in the United States during the 2017-18 season. FluMist will not be available for Vaccines for Children providers to order. 
  • Pregnant women may receive any licensed, recommended, age-appropriate influenza vaccine.

Dosing for Children aged 6 months to 8 years of age

  This figure shows the influenza dosing algorithm for health care providers to use to determine the appropriate dose of vaccine for children aged 6 months through 8 years, as recommended by the Advisory Committee on Immunization Practices for the 2017–18 influenza season in the United States. Health care providers should ask if the child received two or more total doses of trivalent or quadrivalent influenza vaccine before July 1, 2017. (Doses need not have been received during the same season or consecutive seasons.) If the answer is “yes,” then the child should receive one dose of the 2017–18 influenza vaccine. If the answer is “no” or “don’t know,” then the child should receive two doses of the 2017–18 influenza vaccine (administered four or more weeks apart).

Thimerosal in flu vaccine

Thimerosal is used as a preservative in all multi-dose vial presentations of influenza vaccine. A 0.5 mL dose drawn from a multi-dose vial contains up to 25 µg thimerosal, depending on manufacturer. Most single-dose flu vaccine presentations-prefilled syringe, single-dose vial, and prefilled microinjection system-are thimerosal free.  An exception is the 0.5 mL prefilled syringe of Fluvirin, which contains 1µg of thimerosal. 

Expiration dates for multi-dose vials

Manufacturer Trade name Vaccine expires 28 days after the multi-dose vial is opened or accessed (needle-punctured) Vaccine is usable through the expiration date on the multi-dose vial label whether or not it has been opened or accessed
CSL Afluria X  
ID Biomedical FluLaval X  
Novartis Fluvirin   X
Sanofi Pasteur Fluzone   X

Resources for flu vaccine administration

  1. CDC Preventing Seasonal Flu with Vaccination
  2. Guidance for use of High-Dose and Adjuvanted Flu Vaccine in persons 65 years and older
  3. Influenza Causes Substantial Morbidity and Mortality in America's Children Every Year-Facts and Figures on Influenza in Children
  4. Screening Checklist for Contraindications to Inactivated Injectable Influenza Vaccination
  5. Vaccine Information Statement (Flu Vaccine, Inactivated or Recombinant)
  6. Links to Package Inserts for U.S.-licensed Vaccines
  7. CDC Flu Vaccine and People with Egg Allergies
  8. Colds vs. Flu Chart
Contact us

Vaccine Preventable Disease

Kelly Barrows
Vaccine Coordinator

Susan Babcock
Public Health Nurse

Mary O'Leary
Health Educator

Rita Mell
Program Supervisor

Susan Ingram
Program Assistant
Did you know?
Influenza hit Snohomish County hard during the 2016-17 flu season.  There were 458 reported hospitalizations and 45 deaths related to influenza, mostly in seniors.